Law reducing cost, increasing health care access passes Senate
by W. Brian Hale
Apr 17, 2013 | 3671 views | 0 0 comments | 13 13 recommendations | email to a friend | print
A bill aimed at lowering costs and increasing access to health care passed the Alabama Senate Tuesday with overwhelming bipartisan support.

Senate Bill 229, sponsored by Sen. Greg Reed (R-Jasper), authorizes the Board of Medical Examiners to allow Certified Registered Nurse Practitioners and Certified Nurse Midwives to prescribe certain schedules of controlled substances.

Reed said Alabama is one of only two states in the country that does not grant prescriptive authority to these advanced practice nurses.

“First and foremost this legislation is about doing what’s best for the patient, and increasing their access to quality health care,” Reed said. “We also have to look at the number of highly qualified nurses who are leaving the state of Alabama to go practice in a state where they have greater prescriptive authority and take steps to resolve that issue.”

The concept for the legislation has been discussed in Alabama for more than a decade, but it became a priority after it was recommended by Senate President Pro Tem Del Marsh’s Streamline Alabama initiative as a way to cut costs and increase access to care.

“Particularly in rural areas of our state, there is a shortage of primary care providers,” Marsh said. “We’ll now have the ability to tap into a new resource to help fill in those gaps. I want to thank Sen. Reed for the work he’s done on this important legislation over the past year and a half.”

Reed added that the legislation has a coalition of support, most notably from the Nurse Practitioner Alliance of Alabama, the Board of Medical Examiners and the Medical Association of Alabama, which represents physicians. According to a study conducted by the Nurse Practitioner Alliance, nearly 90 percent of nurse practitioners support the bill.

David Jones, executive director of the Capstone Rural Health Clinic in Parrish, applauded the passage on the bill and expressed his gratitude for the efforts of legislators in the senate and in the House of Representatives. The House passed Bill 307 recently, which also authorizes “nurses, midwives, assistants, Board of Medical Examiners to create Limited Response Schedule II permits for certain nurses and assistants, authorizing the prescribing of certain controlled substances.”

“We are appreciative of Sen. Reed’s leadership in the passage of this legislation (SB 229) which will improve care to the citizens of our state. We also are thankful to the House counterparts who did the same in the last few weeks (HB 307),” Jones said. “Nurse practitioners in Alabama are eager to meet health care access needs in the state and advanced Practice Nurses can deliver safe and effective care. This bill will contribute significantly to the care delivery system challenges we face in today’s health care environment.”

Reed said he was touched by a story relayed to him by a nurse practioner about a patient’s care being delayed due to the provider not being able to write pain medication — a story which he kept in his mind while writing the legislation.

“The nurse practioner’s patient was an elderly lady who had cut her hand while canning — an injury that could be sewn up — but with the restriction on nurse practioner’s prescriptive authority, she wasn’t able to prescribe medication for the pain the patient was feeling,” Reed said. “It took nearly an entire day before the nurse practioner was able to track down her collaborative physician to get a signature for the prescription, during which the patient had to suffer the pain of the injury throughout the entire period. Stories such as that were the driving force behind this bill. With this legislation, nurse practioners will have the skill set to take care of a patient’s need, as well as being able to fulfil treatment in the cases where medication is needed.”

The bill passed with enormous support by a 27-1 vote.

“Republicans and Democrats warmly embraced this measure — because not only here in our district, but across the state, more health care access is needed — especially in rural areas, so medical conditions do not have to go untreated,” Reed said. “When health concerns are diagnosed and addressed quickly, the cost of the care is reduced than over a situation where a condition is delayed and turns into something more serious. Initiatives like SB 229 is beneficial for everyone and I’m proud to see that we have the support to have it passed.”